Our workers’ compensation laws represent a great compromise between management and labor. In comparison to other types of personal injury claims, it is relatively easy for injured employees to recover money for workplace injuries; however, the amount of recovery available is generally less than would be available in other types of personal injury claims. Despite this, workplace injuries can result in a huge expense for employers. In seeking to control that expense, it is important for businesses to understand at least the basics of workers’ compensation law.
What injuries give rise to a workers’ compensation claim?
Compensable workers’ compensation injuries are those:
- Caused by an accident;
- Arising out of the employment; and
- Sustained in the course of employment.
Notice that the first requirement is that the injury must be due to an accident
. Generally, to qualify as an accident, the incident giving rise to the injury must be some departure from the normal routine. For example, a paint can falling on a painter’s head clearly constitutes an accident. In contrast, a rotator cuff tear sustained by an employee while emptying the same trash can that employee empties every shift might not. There are some exceptions to the accident requirement, the most notable being spinal injuries, which are compensable as long as they occur at a distinct time, even if not caused by any accident. Applied to the example above, the same employee who was out of luck after injuring his shoulder taking out the trash would indeed have a valid claim if he instead injured his back.
The “arising out of employment” requirement means that there must be some rational connection between the employment and the injury. A carpenter who smashes his thumb while hammering a nail has clearly suffered an accident “arising out of” the employment. However, if a plane falls from the sky and injures that same carpenter, his injuries will not be compensable under workers’ compensation because there is no relationship between carpentry and the risk of being hit by a falling plane.
The “sustained in the course of employment” requirement refers to the time and place of the injury. In other words, was the employee “at work” when the injury occurred?
Note that nowhere in this discussion is there any mention of fault.
Fault on the part of the employer, or even the employee, is usually irrelevant. If an injury occurs that meets the above criteria, it is typically compensable.
Finally, in addition to injuries by accident, occupational diseases can also give rise to workers’ compensation claims. A classic example of a compensable occupational disease is a cotton mill worker suffering COPD after years of breathing cotton dust. Occupational diseases can also arise by repetitive motion attributed to the job, as in the case of a typist who develops carpal tunnel syndrome.
What recovery is available to injured workers?
In broad terms, the workers’ compensation scheme is meant to compensate injured workers for lost wages and medical expenses. There is no recovery allowed for pain and suffering, emotional distress, loss of consortium, or some of the other elements of damages that are available in typical personal injury claims. Employees who are left with a permanent impairment may also be eligible to receive money for an “impairment rating” to the injured body part. In the most serious cases, employers and their insurance carriers may be responsible for paying an injured employee’s lost wages and medical expenses for the rest of that employee’s life.
Tips for limiting workers’ compensation exposure:
- Implement, and enforce, appropriate safety policies and procedures.
- Supply and require the use of appropriate safety gear.
- Discipline employees who violate safety protocol or fail to use safety gear.
- Require immediate reporting of all workplace injuries, no matter how seemingly minor.
- Promptly report any injuries to your workers’ compensation insurance carrier.
- Stay involved, even after you turn over a claim to your insurance company. An adjuster might have literally hundreds of claims to manage. Don’t be afraid to advocate for the effective management of yours.
For more resources and information on workers’ compensation claims in North Carolina please visit www.cshworkerscomp.com
This content has been prepared for general information purposes only. This information is not intended to provide specific legal advice. Legal advice is dependent upon the specific circumstances of each situation. The information provided cannot replace the advice of competent legal counsel by a licensed attorney in your state.
Benton L. Toups is a partner at Cranfill Sumner & Hartzog LLP and serves as vice-chair of the Employment Law Practice Group. His practice concentrates on representing businesses in all aspects of labor and employment law. A firm believer in the adage that “an ounce of prevention is worth a pound of cure,” Toups counsels employers on day-to-day issues and assists them in developing and implementing policies to avoid employment litigation. To contact Toups, call (910) 777-6011 or email him at [email protected].